How does the Medicare Chronic Care Management program relate to MIPS?

CCM can help with MIPS score

  • Chronic care management is a major focus of MACRA in general. While the final rule is still being drafted, the proposed rule provides several examples of how implementing a chronic care management (CCM) program will benefit you MIPS score. CCM primarily impacts MIPS through Clinical Practice Improvement Activities (CIPAs), in particular how comprehensive care plans, a requirement of the CCM program, count towards both Medium and High priority CPIAs.

  • Using and maintaining comprehensive care plans alone for certain common conditions in primary care could allow a practice of 15 or fewer providers to achieve 15 out of the 15 points assigned to CPIAs. Larger practices may also achieve the highest possible score through the implementation of a chronic are program coupled with other CPIAs

  • Coordination of care is a primary focus under the majority of MACRA components, including the APMs. A CCM program will achieve many of the goals under APMs.

  • How much revenue can be expected from a CCM program?

  • Depending on the number of patients you enroll in the program, the reimbursement may vary from a few hundred dollars a year to well over $100,000.00 in additional revenue. For example, if the practice bills and in reimbursed for an average of 100 patients a month in the CCM program, the revenue generated will be over $50,000 per year.

  • What are the basic requirements for the CCM program: